⚧️The WPATH Files⚧️
A damning new report from Environmental Progress, based on leaked internal documents from the World Professional Association for Transgender Health, asserts:
WPATH is “neither scientific nor advocating for ethical medical care.”
For the details see the 🧵⬇️
The #WPATHFiles quote WPATH members saying:
⚧️Gender-transition treatment is given to those with at best a limited capacity to consent
⚧️Treatment can have serious side effects
⚧️Minors often don’t understand the long-term risks
⚧️Detransitioning is conceived of as trivial
Largely U.S. based, @WPATH is an “interdisciplinary professional and educational organization” that produces influential guidelines for treating gender dysphoria. It’s not a standard medical society like the AMA. Many members are neither physicians nor mental-health providers.
The #WPATHFiles quote physicians discussing serious adverse events in patients after gender-transition treatment and surgeries, including:
⚧️Liver masses and cancer
⚧️Erections “feeling like broken glass”
⚧️Pelvic inflammatory disease
⚧️Pain with orgasm
⚧️Bleeding after sex
The #WPATHFiles report finds that WPATH members express public confidence about gender-transition treatment for minors while in private they express uncertainty and concern—such as regarding the ability of children, and sometimes even parents, to understand the serious risks.
The WPATH Files quote internal messages from Thomas Satterwhite, a California surgeon, who describes surgeries he’s conducted to create bodies with no natural equivalent, including:
⚧️Mastectomies without nipples
⚧️Vaginoplasties that leave the penis
⚧️Genital nullification
One WPATH surgeon sought advice on whether to perform a vaginoplasty on a 14-year-old patient. Dr. Christine N. McGinn said she’d performed about 20 such surgeries on minors in two decades and battled her hospital to do more where she deemed it “sound medical practice.”
These @WPATH leaders suggest that minors often can’t understand the implications of medical transition:
⚧️Daniel Metzger, endocrinologist
⚧️Dianne Berg, child psychologist, coauthor of the @WPATH Standards of Care 8 child chapter
⚧️Christine McGinn, plastic surgeon
Dianne Berg, child psychologist and co-author of WPATH's child guidelines, said minors can't consent to gender care, and said: “But what really disturbs me is when the parents can’t tell me what they need to know about a medical intervention that apparently they signed off for.”
The #WPATHFiles report asserts that WPATH follows “an unethical approach to consent among adults,” and sees as able to consent to gender-transition treatment those with:
⚧️Dissociative identity disorder
⚧️Other severe mental health diagnoses
⚧️Major psych diagnoses + homelessness
The Environmental Progress’ report excoriates WPATH, saying:
“The WPATH Files reveal that WPATH is neither a medical organization nor a scientific organization. The group is engaging in an unregulated experiment on some of the most vulnerable individuals in society.”
WPATH, the WPATH Files report says, “advocates for a transition-on demand style of care, valuing patient autonomy over avoidance of harm.” And, it says, “notably absent...is any consideration of the ethical concerns surrounding surgeries that destroy healthy reproductive organs.”
At least one @WPATH member leaked a trove of communications from an internal message forum to Michael @Shellenberger in 2023. For Environmental Progress, Mia Hughes @_CryMiaRiver led a 216-page report.
Dr. Marci Bowers, president of @WPATH, said on an internal message board that “acknowledgement that de-transition exists even to a minor extent is considered off-limits for many” in the trans community.
One researcher sought to reframe detransitioning as a non-negative outcome.
Jamison Green is a trans-rights activist, former WPATH president and a coauthor of a 2020 WPATH statement saying that in general, mental health and medical professionals evaluate gender dysphoric youths before OK’ing gender transition treatment. In private, he contradicted this:
WPATH leader Dianne Berg said that she is “stumped” about how to communicate the risks of fertility loss to a gender dysphoric 9 year old.
Daniel Metzger said gender-transition treatment is “to a degree robbing these kids of that sort of early-to-mid pubertal sexual stuff.”
The authors of the #WPATHFiles report call for “a national inquiry to investigate how activists with little respect for the Hippocratic Oath could have risen to such prominence as to set the Standards of Care for an entire field of medicine, leading [to] medical abuse.”
The #WPATHFiles report argues @WPATH members are “improvising, experimenting without a structured framework” on trans-identified youths.
WPATH president Marci Bower said in a 2022 forum, speaking about puberty blockers’ impacts, that the “fertility question has no research.”
A gynecologist told WPATH colleagues of a patient who after receiving a vaginoplasty, had prostate secretions leaking via the urethra. There’s no remedy for this. A nursing lecturer said to tell the patient to “enjoy the ride,” as it’s a sign of orgasm and “What's not to like?”
Surgeons often won’t perform elective surgeries on high-BMI patients given the associated risks. WPATH members scoffed at such a barrier in their private forum, lambasting it as “systemic fat phobia.” WPATH member Dr. Scott Mosser, however, operates on people with a BMI up to 65.
The authors of the WPATH Files report could find only 1 instance in the leaked WPATH internal messages in which members expressed concern about the potential dangers and adverse effects of gender-transition treatment: about a trans female who wanted to lactate but had no infant.
“WPATH is held up as the source of all knowledge about gender-affirming care, but the scientific basis for their recommendations is exceptionally weak,” the #WPATHFiles states. “The group exists solely to shield doctors from legal liability...and to ensure insurance coverage.”
The authors of the WPATH Files report claim @WPATH values “patient autonomy over risk aversion.” The organization, the authors claim, “conceptualizes harm, as in ‘do no harm,’ as unfulfilled consumer desire.” The authors conclude: “This is a violation of medical ethics.”
“WPATH has broken the chain of trust in gender medicine,” the report asserts. It “presents itself as scientific but is, as the files reveal, an advocacy group promoting risky, experimental, and cosmetic procedures in the guise of well-researched and ‘medically necessary’ care.”
The #WPATHFiles report includes the names of quoted people who are in WPATH leadership but redacts those of others and only generally describes their professional position and location.
eg: An activist and law professor with no medical training at the University of Alberta:
The author of the #WPATHFiles report, Mia Hughes @_CryMiaRiver, contacted each named @WPATH member who is quoted in the report, seeking comment. Only one WPATH member responded, and with legal threats. None claimed the internal messages were inauthentic.
In one WPATH message-board exchange, a Canadian nurse practitioner said she was struggling over whether a severely mentally ill patient should start hormones. Dr. Dan Karasic of @UCSF, lead author of WPATH’s Standards of Care 8 mental health chapter, scoffed at her hesitancy.
The #WPATHFiles feature the following internal message from Dr. Daniel Metzger, a Canadian endocrinologist. He portrays young people as naive about foreclosing on their ability to have biological children through gender-transition treatment.
Endocrinologist Daniel Metzger acknowledges to his @WPATH colleagues in internal messages that suppressing the puberty of gender dysphoric natal boys at the onset of puberty prevents them from learning to masturbate and from thus producing a sperm sample to preserve.
The WPATH Files report authors say that health care providers should reject @WPATH’s guidance and instead follow the systematic literature reviews from Sweden, Finland, England and Florida that found the evidence backing youth gender transition “insufficient and inconclusive.”
WPATH members, the report shows, repeat the common claim that prescribing puberty blockers or cross-sex hormones to gender dysphoric youths is life saving. Finnish researchers published a study last month that found no evidence to back this claim:
I covered the #WPATHFiles in my S****tack. This is essentially my Twitter thread on the subject distilled into an article form: benryan.substack.com/p/the-wpath-fi…
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NEWS: Alabama Attorney General submits motion for summary judgment in District Court case over ban on pediatric gender-transition treatment.
The document offers a scathing @WPATH's credibility, based on subpoenaed documents, dismissing it as an "activist interest group." 🧵
This summarizes the Alabama Attorney General's assessment of @WPATH, based on a trove of subpoenaed internal communications that have been unsealed this week, plus more yet to be unsealed: "In short, neither the Court nor Alabama need treat WPATH as anything other than the activist interest group it has shown itself to be. The Constitution allows States to reject WPATH’s model of “care” and protect vulnerable minors from life-altering transitioning “treatments.” The Court should grant Defendants summary judgment."
The AL AG's motion for summary judgment borrows liberally from the UK Cass Review to portray the scientific literature on gender-transition treatment as weak and unreliable. It also relies on the words of @WPATH's president, Dr. Marci Bowers: "Asked whether 'reasonable people could conclude that there is not enough evidence to support the safety or clinical effectiveness of puberty blockers,' Bowers replied: 'There’s not enough high level evidence. Yes, you can – you can – you can say that.'”
Dr. Amy Tishelman, a Boston College psychologist, reached out to me to say that what James Cantor wrote about her in his report on internal WPATH communications is incorrect. Her statement is in the screenshot below.
She stated: "Item 140 in the Cantor report, claiming that I was discussing minimum ages for surgery at a WPATH meeting is false. I had nothing to do with writing any chapter in WPATH related to medical or surgical intervention of any kind and never referred to that in my talk, which was about guidelines for prepubescent children and the SOC8. At the time this story first came out I was horrified, and WPATH released a statement characterizing this out of context information as 'Dangerous Misinformation.' Please see the attachment below for a copy of the WPATH statement about this."
Here is the document to which Dr. Tishelman referred:
Here is the video in question from which James Cantor quoted Amy Tishelman. She says that she is being misrepresented. It is possible the video is missing a part in which she clarifies her statement, but I am not sure.
Claim of Suicide Surge in Youths on U.K. Wait List for Gender Care Undermined by ‘Cass Review’
🧵: I report for The @NewYorkSun: The report on pediatric gender care also undermines suggestions by @GoodLawProject's @JolyonMaugham that after the Tavistock v Bell decision in Dec. 2021, the UK GIDS pediatric gender clinic all but eliminated gender-transition treatment referrals in 2021 and that this drove a wave of suicides on the waiting list.
The @GoodLawProject said there was a “huge increase” in suicide deaths in those on the waiting list for the UK's pediatric gender clinic, GIDS. @JolyonMaugham said the clinic’s harsh restrictions, starting in 2021, on treatment access drove the surge.
🚨BREAKING: Unsealed documents in suit over Alabama pediatric gender-transition treatment ban reveal inner workings of @WPATH
One exhibit is an export report by Canadian sex researcher @JamesCantorPhD, who has served as a paid expert testifying in favor of state bans.
See: 🧵
Cantor provided redacted internal @WPATH communications that portray the trans medical-activist group as bending the science to suit the narrative when drafting the Standards of Care 8 (SoC8), and in particular to aid in lawsuits and battles against unwanted state legislation.
"WPATH views evidence-based medicine as an obstacle to its policy goals, rather than as an important tool to beneficent health care for patients," @JamesCantorPhD writes.
WPATH members acknowledge that in developing the SoC8 guidelines for trans care:
▶️They didn't use the GRADE system to evaluate the quality of evidence.
▶️They are "painfully aware of the gaps in the literature."
▶️They acknowledge that the "policy changes" in Europe, Australia and New Zealand (restricting access to pediatric gender-transition treatment) pose a "threat to our assertion that the WPATH SOC are the Gold Standard used around the world."
▶️Chair of the SoC8 Steering Committee Dr. Eli Coleman sees as adversaries skeptical academics and scientists who pressure "health care to provide evidence-based care." This suggests, Cantor asserts, that Dr. Coleman sees evidence-based medicine itself as a threat, and thus does not see SoC-8 as evidence based.
I'm listening to Part II of Michael Hobbes 3-hour takedown of rapid onset gender dysphoria.
So far he and his @MaintenancePod cohost, @yrfatfriend, have heaped scorn on @LisaLittman1 for her 2018 ROGD paper, saying she based her survey on the thoughts of what they characterize as anti-trans parents found on a fringe anti-trans website. Then they have similar scorn for J. Michael Bailey, a professor at Northwestern (@profjmb). They call him a "disgraced" academic and laugh maniacally at a passage from his 2003 book, The Man Who Would Be Queen, and have many chortles and giggles over the so-called "f--ksaw" incident.
Then they turn their attention to England's GIDS clinic and say that the Bell v Tavistock case is one of many coming from what they call the anti-trans movement that inadvertently proves ROGD doesn't exist and how kids are never given puberty blockers and cross-sex hormones after only cursory assessment. They describe how slowly Keira Bell's treatment path unfolded.
Then they say that puberty blockers are only restricted for trans kids and not for cis kids and that this is straight-up discrimination. Hobbes is adamant that blockers are indeed just a pause and that they don't cause lasting effects.
See the 🧵for some fact checks.
British neuropsychologist Sallie Baxendale's recent review paper found that the neuropsychiatric impacts of puberty blockers when used to treat gender dysphoria remain largely unknown. There is a change they may lower IQ. Much more research is needed. pubmed.ncbi.nlm.nih.gov/38334046/
There is a big difference between using puberty blockers to delay precocious puberty to its optimal start point to delaying puberty past its optimal start point for gender dysphoria, note.
I listened to part 1 of Michael Hobbes' very long take-down of rapid-onset gender dysphoria in @MaintenancePod.
Here's his thesis: A mass conspiracy and moral panic has emerged from the lamentations of moms on a single anti-trans, fringe website with the goal of convincing the public that social contagion is causing a large number of kids to become trans when they're not and then go and get on blockers and hormones after only a cursory evaluation.
In on this baseless conspiracy borne out of hysterical, anti-trans moms, Hobbes asserts, are journalists such as @JesseSingal and @kittypurrzog and the publications they wrote for, @TheAtlantic and @TheStranger.
Hobbes is adamant throughout the episode that social transition cannot cause someone to become or otherwise identify as transgender. He is adamant that no child ever accesses puberty blockers and/or hormones after a swift and shallow assessment period. (Reuters reported that a handful of clinics will provide gender-transition treatment to minors after the first visit if there are no red flags, note.) And he insists that the true problem is that parents don't have faith in their children's perceptions of their own gender identity, just as parents once doubted their kids could be gay and assumed homosexuality was the result of pernicious social influences.
Hobbes and his cohost, @yrfatfriend, have copious derision and scorn for the parents they quote who express concern that, the parents say, their kids suddenly identify as trans after never displaying any gender incongruent traits and after multiple people in their friend group do so. They do not believe these parents when they say they are not opposed to transgender people and insist they are actually anti-trans bigots.
Hobbes also insists that other forms of social contagion reported in medical literature do not occur. He dismisses studies that indicate that mental health problems transmit through populations and that gun violence is socially contagious. (He does not mention suicide, which is widely known to be highly socially contagious.)
He and his cohost spent much of the more than 90-minute episode laughing derisively as the points of view of those who believe that rapid onset gender dysphoria might occur or do occur. @RottenInDenmark
In sharp contrast to the certainty of Michael Hobbes that social influences cannot contribute to a person identifying as transgender, Britain's Cass Review states: "There is broad agreement that gender incongruence is a result of a complex interplay between biological, psychological and social factors. This ‘biopsychosocial’ model for causation is thought to account for many aspects of human expression and experience including intelligence, athletic ability, life expectancy, depression and heart disease."
The centerpiece of Hobbes' takedown is Lisa Littman's highly controversial 2018 paper on rapid-onset gender dysphoria, which remains a contested theoretical psychological and social phenomenon. psycnet.apa.org/record/2018-41…